S 2841 APPLICANTTOFILL IN INFORMATION WITHIN RED LINES—USE BALL POINT PEN ONLY
CITY OF CUPERTINO - BUILDING-ELECTRICAL PFRMITNO.
BUILDING DIVISION APPLICATION/PERMIT' PIAMRING-MF.CHANICAh
BUILDING PROJECT IDENTIFICA'PIUN'. .-t
it
BUIAING.DDRES : L 3 SANITARY NOA PLICAT( MDATE
2 ) /
OWNER'SNAME: 0 !J� e,. IIONF.: CONTRACI'OIZ'$NAME: LIC NO:
,✓ lr�' NIC CONTROL#
•ARCHITECT/ LIC NO ADDRESS: - ❑ Q ^/ D
J L/
TAC-f, - PHONE, _ 'BU 1LDIbl PERMIT INFO"
- ❑ Consultant Fees Paid by Applicant(Initial) BLDGELECT PLUMB M,EECCHH
L / Q--
CENSED CON' ACTOR S DECLARATION QTY ELECTRIC FEE' 'a
I hereby affirm that I am licensed d provisions of Chapter 9 Roconecurin, , Pt e.. -� JOB DESCRIPTION
®a'Z with Secfan]W07 of D' ,m3 of Bus m,,u Jmy limm,ols . . R L; -
O s.l PERMIT'ISSUANCE
F1_ in full farce and ellen. r n SFIDSE ❑KI'T'CHEN REMODEL
d ZUZU License Cle,: LIcN APPLIANCES-RESIDENTIAL ❑ADDITION Ll PLUMBING RE-PIPE
N 6 L Dan. Cna(octan
�n CHITECI"S❑ECT. DMULM-UNIT ❑SI'kULTURAL
FNZ. I understand my plumsshall be used.spuhlic records PANELS - MODIFICATION
OZ4- _ UP'10200 AMTS .
OZ-� - _ L1 INTERIOR [_1 CHIMNEY REPAIR
'F�.F'.,W Licensed Professional 201-I000AMPS IMPROVEMENT E]SWIMMING POOLS
OWNERBUILDERDECLARATION OVER 1000 AMPS ❑BATH REMODEIJREPAIR ❑DEMOLITION
I% d 1 homey v1Lrother I aT exempt from the Contractor's License Law for the
O OTHER
U fallowing reason.Scene,10315fe
.Business and Prossions Gde:Any Thy ritually SIGNS ELEC'T'RICAL
W'w ty vi which requires a permit to construct,alcor,it ease dmmlish, a mpmr any struemre _
"tprior t issuance, y' th ppli tfor such permit t file a signedL%ttement SPECIAL CIRCUIT/MISC.G�"i ray that he is liven,edp r If,pro pre",o:c.f the Contract., License' t (Chapmr9
A+E`SOO Di g thSecl 7000).1D" i fth B : .' JP f GNe),r TEMP.METER OR POLE INST. COMMERCIAL'
that he is exempt theralrouland the basis for the II g J exemption.Any violation of ❑NEW BLDG/ADDFHON ❑DEMOLITION
iC m 4 Socio,7031,5 by any ppreme for. ourt sublectc the appl.tum.civil pen ally of POWER DEVICES
WFog reunion,
tmon,than tied hundred dollars l$500) [1 TENANT
❑FOODSFRVICR
IMPROVEMENT
T ofthe person, y employees with ages atheir ouria t m, SWIMMING PO
IC
' CO 'dI do the I.and the structure t[intended motheredRussia(S 9044, -Business - ❑OTHER t
li]a ro and P f a Code'. fh C l 'I is License' La does t ,ply t ua w of OUTLETS-S CH ORES1 /10
0• p..Perry who bonds m Improves Damon,and who does such work himself or through ,
his own employees,provided that such imu pmeamenare not intended or offered for NEW RESIDENTIAL ELECT SQ FT.
sale,If,however,t6ebuilding orimpmverromis sold within one year of mmpletl",the SQ.FT.FLOOR AREA $ISQ.FT
er-amider evil l h rso'the burden of proving that he did am build or improve for put
-
Ease cfsale,. p� p.
E] 1,as aware of the property,nT exclusively contracting with licensed curvatures;to L° eL
construct the project(Site 7044,Rname,,and Prior e..ions CodeJ'the Contractor's Li- -
lease Law don not apply to an owner ofmopery who builds or improves lhawor,and ,QTY. ' PLUMBING 8 FEE
who contracts for such pr9ect,with sentimentalist licensed pnnu ect{o the Commemes
License Law. PERMIT ISSUANCE
(]Iamcxempt ander So,. ,B A,P C for tcitation
ALTER-DRAIN&VENT-WATER(EA) VALUATION
Owner Unle ^'7
WORKER S COMPEN SATION DECLARATION BACK FLOW PROTECT DEVICE �S ,07 �1
II bya1Em J penalty ofpjury ane of Ne following- declarations: - V
❑ IM1 d illmn to C of me of Cmvmd to self m' f W ka's Camper, DRAINS FLOOR,ROOF,AREA,C STORIES TYPE CONSTRU TION
ion,as provided fa by Section 3700 of the Labor Code for the pe f r anew of _
kfwhichthis permitis' J. FIXTURES-PER TRAP '7 /
I have and will maintain Worker,Campe�alicn lasmrence,as required by Sema. L� (/
3AAl of the Labor Cade,for the performance of the work for which this permit i s issued. GAS-EA.SYSTEM-1 INC.4 OUTLETS OCC GROUP - APN
My Worker,Cone,...tion Insurance eerier and Policy mmfflber,arc:
Carrier: Policy Nei GAS-EA.SYSTEM-OVER 4(EA)
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE GREASFAINDUSTRL WASTE INTERCEPTOR
(Thi,semina need not be completed ifthe permit is Intone hundred dollars($100) RUTLIRl DIVIS "
IQN' &S`
orlesaJ
GREASE'IRAP PLANCI IECK I-irE - - O
I certify that in the performance ofthe work for which this permitls issued.lshall SEWER-SANITARY-STORM EA.2(m FL
not employ any Perron m any cannot in as m become subject to the Wodrera'Cocpeo- ENERGY FEE �0
�rz Applicant cabs.Laws of Cabforni..Dore WATER HEATER WNENT/ELEC R
zs GRADING FEF:.
,.. y NOTICE TO APPLICANT.If,after making this Certifiale of Exemption,you should WATER SYSTEM/REATTNG
F become tableect m the Worker'.,Compensation provisions of the Labor Code,you mm� SOILS i>EE
4akl r'�.t forthwith comply with such prov.,iws or this permit shall be deemed revoked WATER SERVICE -
P, z
CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PLMB. SQ.FT. PAID
UO - pate Receipt q_
T ltcrmby affirm the them i.v n cnnsvucnon lendb,g agency for the performance of -
the work for which this permit is issued(Sec 3097,Civ,C.)
G" E'' Lender's Name 'TOTAL:
U Lender's Address TOTAL:
'�•� 0. I con fy init I fiescorearl this ppl cafe u and state that the bo f i n is BUILD G .P —
N. la eorect I agree to comply with all city and county ordinances and state laws relating to QT ..• MECHANICAL PERMIT i FEE -
U ,$ buildngcomtructme,andherebyauthorizerepresentativesofthiscitytoenteruponthe ' SE 30.940
( above-mentioned property for inspection purposes. PERMIT ISSUANCE ' ELECTR PEE s 4,79 -s
,
(We)agree m save,indemnify and keep harmless the City of Cupertino against
liabilities judgments,cots and expenses which may i n any wary same against said City ALTER OR ADD TO MECH.
in onw,recoeeot'the grismin,of this permit PLU ENG FRE
APPLICANT NDERSTANDS AND WILL COMPLY WITH ALL ON-P INT AIR HANDLING UNIT(TO 10,000 CPM) -
SOURCER a ATIONS. � � MECH NICAL PEE
AIR HANDLING UNIT(OVER 10.000CPM) CONSTR CfIONTAX
S,gnamre plica to EXHAUST HOOD(W/DUCT) HOUSING MI'T'IGATION FEE
HAZARDOUS MA'T'ERIALS DISCLOSURE
Will the applicant or furore building occupant store or handle h.zardous material HEATING UNIT(9'0100,0n)RTU)
as defined by the Cupertino On...r,ul Code,Chapter 9.12,and the Health.ad Safety
Cods,Section 25532od.1 HEATING UNIT(OVER 100,000 BTU)
E]Ycs
VENTILATION PAN(SINGLE RE$ID) PAID '
S} Will the uplifter, hardfcompact yreciprocal teawhich Date Receipt%
emh hzmdou .ir rcvmitact,a defined by tiro Buy Area ir Quality Mnemem BOILER-COMPQHPOR IOLOWBTU) TO
TAL
DiatnctEl Yet, BOILER-COMP(OVER 100,000 BTU)
AIR CONDITIONER
IF Tad thehem uc vreried,resume an,,under Chapin 645of the Cali- ISSUANCE DATE
I, Heah & 'afmy Cad,Se turns U5,25533.nd 25534.I made and thi f the NEW RESIDENTIAL MECH. SQ.PI'.
taildu al cmlyhavcutc tad titinmyrcapmnsibility to a(y the mpint
+ .,,he o no be orm axwnccufaC
Owner tion vgemate TOTAL: ISSUED BY:
OFFICE
�2la GRiTT`�7-- W4r'1' UK1HI'1 P.NIYOHG f .llLY - ..; .� .� .-
Brian Kangas [bulk
Enoineers Surveyors ( Plennsrs
• Docember20, 1999 - -
560069.50
Couch Schoenberger
O'Brien Group ;
2001 Windward w4y,Suite 200
San Metra,CA 94404
i
Sobjoet: OakVYllity"roundation Vcrifleation
• Dev Chuck,
On Deteri 20,'1999 we performed a Field survey of the loeation of the foundation forms for the
bulldlugs being constructed un Lots 4.03,1.05',4.33, 6-d�4.94 of&Oak Valley project in Cuponino.
711e results of thai survey clearly shot-that rhe location of the foundation forms&Pa consistent and in
conformance widl the design locatleu of lie buildings,as said locations are shown on the pians prepared by
our RM,
This letter is iotsAded to provide you with the verification of those units per our sdr)ey. If there an any
other quostiuns coneert ing that location, pleasn do not hesitate to call.
Sincerely, FICUIZW .
40 I.PNO S°v�,1
N °om,
BRIAN Y.ANGAS ItOULF 4l 0R W9MARTIARTI
• Di1ly Mutln, PLS 5797 w N6 6707
Expires: 06/30,12000
94C Pllee Avenue 1 Pe(woaa City,CA 94665 1650)482.6300 FAX I66[lI 462.63110
DATE Jca W.
Consulting Engineers and ,�cibntists z z2 '4S i <lo. -r
425 ROLAND WAY PROJECT . .
OAKLAND, CA 94621 (,� lc
(510) 568.4001 LOQ'10N
CONTRACT OWNER,
�PI',QP.'�1,�:1✓..Y' �.�' 14PYI LL�V�J(/;l(:'� WEATHER Temp.'. ' NV'at AM
ale `
'70°al PM
Hours Charged To Project •C' Nucltiar Density Tests « PRESENT AT SITE
Field Task Number u`''''+ Cincrete Cylinders _
THE FOLLOWING WAS NOTED:
fir, `�.1'-C U`, i'r C7 ! r^:�I'S C, Irv.%!^ �•-(.�'
(A,„�-( ''f• Oar S { ,+\ P .^,PC' m' -�' r't//2e I- L�JI M )I r"n ! r I I C,H�tx r, C e” I—
G✓J":G1".?e.CI Cr„ C'Ct-C.L"t\ F'C`l.l:v,cl G, 11 Oy\ C• !I
t�{}C1P� .",U': I;vA-p 1- il" r14' (\C' I'�i21Y.lt �'- ••-X�,•,v�'.0 ;IC .f..J�•_• I'r r'IYIc h61/\ i t-r'f� .
-- fl..,fi C(8Qn� U�{- t��P L'•,v' ('�'r �i?fi,�P„ I� Ic\1't r' �G.( � i G I SG C C.CC7C...'� I-C.01 �Y!,^
(i.,..CA C I['1 S Le ? ��.\� C CC'L 1.".) IP
i d
! H n wZ r 0.
f1.�' '�"\ -ta �`,`Y,'vv {"- 7GG.' G.C.�- IR'I•-I.','.i CS., ,G� --//"-'j>?T:��/ i C��:�l,l r ."1 �.tT.C`(tY T LI�✓�C.
CG\'\(`1'Y' I�f nIC.(fir/1`vile\-� I1•Y_ �'IGCi (\-1
I
y
2
COPIES TO G�E51.1 f S 1�f"' OO� JJ/
SIGNED
CLIENT
r
ENOINEERINO WEST INC.
i OBSERVATION CHART
• ' OAK VALLEY DL•VELOPMENT CUPEITTINO.CA.
6001 PETERS SThAU S BRUS, PAGE 1 OF 4
(yyo12]7.007a 11 01207-1923 =DATE: 7.124000
HIS CHART INDICATES THE DAYEB AT WHICH EACH COMPONENT OF EACH B XLDING WAS
OBSERVED AND FOUND IN SUBSTANTIAL CONFORMANCE WITH THE DRAWINGS.
LEGEND
N.C. _ CONSTRUCTION NOT COMPLETELY OBSERVED
CORRECTIONS REO'D. LIST GIVEN TO CONTP•Ai3TOR.
FDN. • STEEL REINFORCING,HOLDOWN ANCHOR BOLT OBSEI'JATION
IST FLOOR . UNDERFLOOR FRAMING OBSERVATION
ROOF PLY. - .PL"%1000 NAILING OBSERVATION
• EXTERIOR PLY. = PLYWOOD NAILING, HARDWARE OBSERVATION .
BASIC FRMG. . GL••NERAL FRAMING NO HARDWARE ONSERVA ICN
UNIT I Lot I Plan. I J I Fdn, ts4 Roof P•on jj I Exi0'; aac Pr. r,k ?xslc trrro
4 1 _
4 2
4 3 1 3 20
•2000 5-21..- 00-_ 5.21 000 of m.a. 5.21.200
4 a NIA
4 5 .B ) t2-21-99 _3.220DO 51C'2000 5-21-2090 a,M.a. 5.21.2000
4 9 7B 03/10/99 041 8/221 08[24/139- .06/24/u
4 8 7C 0311 U99 04114190 06/24/90 06114156 07/01(09
4 U 5C 07/09/99 07109!09 07129190
4 10 20 3 103/01/99 04102/99 07120/99 07114190 07 0 9
4 11 38 _ 03/011!'39 04102/99 07101/99 4 08130!99 07/109
4 12 4Ei 3 1%1 / B 1211019Q 01! 1l9PL�_ 01121199 01/251j9
4 13 6C 08126/98 10/09196 11/00199 11113198 --1-2/1 9
4 13 6C AbOtON 1 02/09/09 _ w
0,^.109109 021095fl
4 14 2A 2 02/02199 03101/1!9 061211 . 6104
4 15 5D 2 02/02188 03108/09 06109199 06109/99
4 17 2C 0 / 1/99 !30/ 09!3019.9 07X`6/09
• 4 18 _ 6E 2;F ONUS 12/14/98 12/24/99 03106109 0:1108199
4 20 48 319 0411 59
12/22/98 04114/99 03H8190 0722159 04114/99
4 21 28 : 2 03/19/99 04/14199 07 (99 - 07r27199 _ 08110/00
4 22 5A 2!B U'S 03119/90 04/14/99 07!20(09 07123199 08110199
4 2 •3A 1/12/99 1181 9 1 '' _05-07.00 0610/109
4 24 6D 31BONUS 01112/99 02/17199 05.03.09 04.30•99 5)171
4 25 SC 3 12/23/98 02!16100 04)02199 04/05199 0511459
4 26 1 20 2 0108/99 02/12/99 05110199 04120199 0611159
4 _ _27 4C _ .3 0110859 0210559 04114109 04112199' 05-07.99
4 28 aE 310 U° 1211413 104! 09 0319903/03 99 03%3059
4 29 7A 1 2 11/13/08 12/10/98 I 0211059 021101 9 31 3
4 30 3 C 1111 rt36 12/10106 021 3199 1 2101 9: 0311159
4 31 5P, 310 NUS 02/1259 0311 061 9 0'10 / _ 0611?109
4 32 2H 1 0211259 03/10/00 06111/99 06117199 --0
4 33 0.21-2000_
12.21.99 9-7. 000 619-2000— 0 n/ 00—
NOTES: (PENDING ISSUES(
(1) LOT 13 PLAN 6C FDN. (OF.FIGE OPTION); CORRECTIONS NOT OBSERVVD.
.I n ...! hC V Cn�,,,, I c•Itra r.,�"' .in^i 'r^wl T ,1n_pT
,
3PEE
• urke
Jim Rlploy(SMTPIriplayd0�p,acboli,nol�
Monday, March 00, 1800 2:26 mi
PATOURKE
OAK VALLEY
C�
Llnoar pa(kwny planlinq
I wllhln Ihn Ilnoer park are conalalonl wllh Iho londsc4po
n dO"rf)O 11s prepared by Ihla olflce 'end rovlowod by Iho cllY
990 and conform wllh the prollmindry approvol doumonla,
;play
9n Group, Inc,
� I FINAL PLANNING SIGN OFF.
DATE 00
SIGNATUREQ
SIIITIl100, SANh1ATatl, r;eLINOHNIA7(Inrt,(7> TILLMIONh'(6fn)!17.Oao0 PACSIAIILal6;01a{y,7,(�1
G�vlur� Maanh •I, '�946
FROM CRISJ1 FAX NO. .0313350325 Fk,g. 20 2000 0.1:70PM P5
Coiuu)wrow Roof hisaago meht San dose, luc: ?'
Rey4ienlial Rao 5)sten:
I lnsprcNon Repu r �-r
• Project:��� VNl,(E`/�ldQn:S teaper ton date:
Addrass: /c. City:Q6,vgltlrp elate: CA
Client: T"n u .
Contact; �dl Bur�Ce/D,dq
ROonng Contrictor.k7D.Ot T
CRMinapactor! `L,4kL rL,P1r£ti
Lot Nuin`b0 _�
0����♦•i1�'�♦♦i hr
Typo of Inopoeflon: Rult final
Typo of Roof: Shingle The other,
Underiaymont: Sht Metal Attachments: Vents &Flashing: ..._ Outters: .
Skylights: Pipes: _^
Valleys! Ridges: _ Ewes:
•
Cao//m/m sen(e/O b sbrv-rNO7ations;
CSF ,, S'l.
k } d�� �.m1t, ZEz�, cN N. LtI, Sr�E
4,4 ;RIC 7• ) E % JNSTALLLr4)
• i
i
f O'Brien Group HVAC Commision Check List
HVAC Contractor
`� SeG" S ProieU Oi�.ic V cA\e Ra -'�=3�`- Phase Lot 2� I 0:7-1 'F5 1�O
Street Address City State Zip Code
Date when notice toaommisionsystem was given. I ,JB f
- - Resehed Date
item check - Yes No Nno.Ihtcotredhreaction aadreschedule date Date compsete
1 Gas meter is instaw and valve is operL
2 Powmfeiechical SOPPPI is connected.
Breakers at sub panel ace on. ! I I f
_ 41 Bus ruses are insfaaedal6smmecl.
Discamreci is swr'"80 On-
8 FAU switch is on. V ! ! ! !
Gas is en at
8 27E system is weed in.
FAU hausM. is dean MA damage free.
1 Condensate roles are set WrOl PCSMVO Slope.
17 Crmdetrsale fates are set to sped se nce.
12 Condensate Pan Is efeen and carnage Tree.
13 Re ' erant I""ores are sealed at FAU
141 Duds are sealed and umeshicled
1 T-stat cwmc5ons made at FAU.
18 FAU hoilging panels are secure. I f I I
1 Condensor and cooling 1•att damage free.
18Condensor to pad stm s rolied in for 3alety, X I t I l
19 Condenser penetrations into wag are sealed.
ZD Dissknaar melai contact seperated at condemor. -
21 T-stat connections nude at mrdensor. - ?C
22 Candensor and W are kvei:
3 System filled will reld rant
24Re rant Fmes and caps are leak free. f ! I !
2;'1Cortdenscrhousny panels are secure. ! ! ! !
. - ZM Condensor and FAUtonnededte 13'�
Furnace and AVC run and teswa-
2B Ambierd temperature measured at random areas. ! 1 I 1
29 R " tera balanced throw h our house. X
RegisteM are darna4e free.
31 Registers are free of insulationldeons. ! ! I !
3 Registers are sel kvei to nearest wag.
33 Aa filkris installed r tion..
HVAC Technician signature ' Daie-�
Both signatures required when system has been roily mmmissioned
O'Brien Group Mgr.Signature . Date I / Tum Into quafilyoomrd priorto quality assurance inspection.
{a8e-
o
e
txa»r IGLAsr comr ..tZrIEL Irl INSULATION CERTIFICATION
=6 N. 11th S1. • 8en.Java.-rA-%142 i
This is to certify that insulation has been installed in conformance with the Current energy regulations,
California Admir issttrative Code, Title 24. State of California. the building located at: m
SITE ADDRESS:
FLOORS: ��,/ Z
Mamdac urer QwEffs CORNING Thk:kneWype r—�` R-yelUe 30
m
EXTEMOR WALLS- — -- D
Ma�utaci+ner- WENSC�NWG ThickneseType 3Y1 fl-
value _1S v
0
CEIU"f(3S: m
BATTS: Manufocterer OWENCCORNING Thkkness/fype C�7 fl-Value IQ
BLOWN: Manufacturer 01YENc r•npNING 7h.ekrmso(iypoiAff— R-Value
3$
WeIAhLBag 36 &L Ft.Covered o201b Bogs Ueed y� ---- m
AIR INFILTRATION SEALANT INSTALLED: YES XJ NO E! – w
�.�"" /\ m
GENERAL CONTRACTOR _lite O'Yir;cy1 . .Gro±e 1Ct]VSE. ;6
By: – TITLE: DATE
COAST INS LATION CONTRACTORS, INC, LICENSE # _ 486440 C-2
By: MOY (�6rfnSCo TITLE: PYOLItr�,bN DATE
v
D
I n
INSTALLATION CERTIFICATE (page 1 of 4) — CF-6R
Site re's
ermtt um er
• An installation certificate is required td be postedat the building site or made available for all n(ipropriate inspections. (The
information provided on this forth is;required;however,use of this form to provide the informatjon is optional.) After
completion of final inspection,a copy:must be provided to the building department(upon regdesQ and the building owner at
occupancy, per Section 10-103(b).
EVAC SYSTEMS:
Heating Equipment
Equip. Sof ERclencyt Duct Duct or Healing Heating
Type(pkg. CEC Certified Mfr Name Identical (AFUB,etc.) Location Piping Load Capacity
heal um and Model Number '.S stems 2CF•IR value attic etc. It-value tuthr BIWhr
Cooling Equipment
Equip. CEC Certified Compressor g of Efficiency Duct Cooling Cooling
Type(pkg. Unit Mfr Name and Identical (SEER etc.)' Location Duct Load Capacity
h<at um Made6 Number ' S 'kms CF-IR value attic etc. R•value Btu/hr Btuthr
1. >_reads greater than or equal to.
I, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2) equivalent to or more
efficient than that specified in the certificate of compliance (Form CF-IR) submitted for compliance with the Energy
Efficiency Standards for residential buildings,and 3) equipment that meets or exceeds the appropriate requirements for
manufactured devices (from tha.Appliance Efficiency Regulations or Part.6),where applicable.
Installing Subcontractor(Co.lame)
Signature, Date g
OR General Contractor(Co.Name)OR Owner
W A TFR HEATING SYSTEMS:
Distribution If Recir• 9 o Rated' Tank Ef - External
Heater CEC Certified Mfr •Type(Std, culallon, Idenllcal Input(kW volumes cleney' Standbys Insulation
Type Name&Model Number pointoFUse) Control Type Systems or Btu/hr) (gallons) (EF,RE) Loss(%) R•value
• 2 For small gas storage(rated input of less than or equal to 75,000 Btu/hr),electric resistance and heal puma wlter heaters,Ilse Energy Factor.
For large gas storage water heaters(fated input of greater than 75,000 EIKuhr),list Recovery Efficiency,Standby Loss and Rated Input.
For Instantaneous gas water heaters,list Recovery Efficiency and Rated Input.
Faucets &Shower Heads: ;
All faucets and showerheads installed are certified to the Commission,pursuant to Title 241 Port 6, Subchapter 2, Section
111.
1, the undersigned, verify that equipment listed above my signature: 1) is the actual equipment installed;2) is equivalent
to or more efficient than that ipedifred in the certificate of compliance (Form CF-IR) submitted for compliance with the
Energy 8fciency Standards for residential buildings;and 3)the equipment meets or exceed9 the appropriate requirements
for manufactured devices(from the Appliance Efficiency Regulations or Part 6),where applicable.
Signature, Date Installing Subcontractor(Co.Name)OR
General Contractor(Co.Narde) OR Owner
• COPY TO: Building Department
Building Owner at Occupancy
• n__.t_...� n�......t. a sssoG
POST THIS CARD NEAR FHUINIVr evIU.111 . wnM
CITY OF CUPERTINO
BUILDING DIVISION "BUILDING PROJECT IDEN/I'1O_n ICATI�,., rrSANITARY NO. APPLICAT101'SUBMITTAL D/
BUILDING ADDRESS: .,. t'• / \ �I l ,� .l ^� I
.OWNER'S NAME: /'� y ,.�/.: / / �`
`IIONIp CONI'RACIORS NAME: LIC NU NIC CONTROLM
❑ ' '
ADDRLSSv Z 7
CHITEf LIC NO: / ,.J
-.BUILDING PERMIT INFO
INSPECTIONSMECIL
• r DATE (INSPE6.' ❑ Consultant Fees Paid by Applicant(Initial) mDG ELECT PLUMB
-n Q n fn
FOUNDATION/PIERS/H.D.S. N
INSPECTION RECORD JOB DESCRIPTION
UFER GROUND /� NOTE: ALL GRADING AND DRAINAGE I
ENTIAL SHALL BE INSTALLED TO COMPLY,WITH AIDWL ❑PLUMBIINREMODI
PAD/SETBACK-CERT THE APPROVED PLANS AND CITY OF ❑ADDITION ❑PLUMBLURALNG RE PIP
ED MULTI ❑STRUCTURAL
GARAGE SLABS/PREGUNITE CUPERTINO STANDARDS. MODIFICATION
POUR NO CONLU CRETE UNTIL AB E HAS BEEN TO ARRANGE INSPECTION L ❑INTERIOR ❑CHIMNEY REPAIR
IMPROVEMENT ❑SWIM IEY REPAIR
UNDERGROUND/SLAB CALL AFTERNOONS (1:00 1'M 4130 PM1 ❑BATH REMODFUREPAIR 0DEMOLITION
PLUMBING 777.3228 MONDAY TO FRIDAY 24 HOURS BE• ❑OTHER
FORE REQUIRED INSPECTION. 70B ADDRESS
ELECTRICAL AND PERMIT#ARE NEEDED WHEN PHONING. _
DO NOT POUR FLOOR UNTIL ABOVE HAS BEEN SIGNED
ATTENTION CONTRACTORS: El NEW RLDOI �tITION ❑DEMOLITION
PLUMBING NO PERSON(S)SHALL PERFORM WORK ON ❑TENANT ❑FOOD SERVICE
IMPROVEMENT
MECHANICAL THIS JOB SITE WITHOUT BEING IN,COM- ❑OTHER
ELECTRICAL PLIANCE WITH WORKERS'COMPENSATION
FRAMING VENTS INSURANCE REQUIREMENTS. ,
INSULATION C --� INSPECTION SPECIAL INSPECTION REQUIRED ❑ DATE
PLACE NO SUBFLOOR UNTB:_AB VE HASBEEN'SIONED;%
ROOF SHEATFUDIAP14RAM
PLUMBING
TUBS&SHOWER PAN
MECHANICAL
ELECTRICAL/POOL BOND /
FRAMING/STAIRS/E.EGRESS
INS U LATIONN ENTI LATION
• COVER NO WORK,UNTIL;ABOVE HA& EEN SIGNED.'
EXTERIAL SHEAR/HOLD DOW
INTERIOR SHEARIHOLD DOWN
SHEETWROCK/SHEETROCK SHF.A
EXTERIOR LATH/WSCREED
SHOWER LATH
NO TAPE.OR PLASTER*,UNTIL ABOVE HAS.BEEN'SIGNEW,
SCRAPCH COAT
SEWER/WATER
• TEMPORARY:APPROVALS
OCCUPANCY —
ELECTRICAL i -
GAS
F,INAGS� ,rcri i�K &uftlti „ Mi
GAS TEST
GRADE
FARE
HANDICAP
ELECTRICAL
PLUMBING
MECHANICAL
ENERGY CERTIFICATE OF OCCUPANCY
VISUAL FINAL ONLY '
•
IMPORTANT: IssuANcs DATE„BUILDING
OCQUPANGYGFfBUILDING7IS sP ,R-.ITT b '
PLEASE READ REVERSE SIDE f1EF0
UNTIL°BUILDING IN��'1.I`IS SIGN A BXJB I);DING' CALLING TOR FINAL INSPECTION!! r?
RiktPYi3RRP . . � 3` ' ISSUED BY:
APPLICANT'S POSTING COPY